High-intensity Resistance Exercise Research Articles

Effects of different exercise modes and intensities on cognitive performance, adult hippocampal neurogenesis, and synaptic plasticity in mice.

Exercise can induce beneficial improvements in cognition. However, the effects of different modes and intensities of exercise have yet to be explored in detail. This study aimed to identify the effects of different exercise modes (aerobic and resistance) and intensities (low and high) on cognitive performance, adult hippocampal neurogenesis and synaptic plasticity in mice. A total of 40 C57BL/6J mice were randomised into 5 groups (n = 8 mice per group): control, low-intensity aerobic exercise, high-intensity aerobic exercise, low-intensity resistance exercise, and high-intensity resistance exercise. The aerobic exercise groups underwent treadmill training, while the resistance exercise groups underwent ladder climbing training. At the end of the exercise period, cognitive performance was assessed by the Y-maze and Barnes maze. In addition, adult hippocampal neurogenesis was evaluated immunohistochemically by 5-bromo-2'-deoxyuridine (BrdU)/ neuronal nuclei (NeuN) co-labeling. The levels of synaptic plasticity-related proteins in the hippocampus, including synaptophysin (SYP) and postsynaptic density protein 95 (PSD-95), were analyzed by western blotting. Our results showed no significant differences in cognitive performance among the groups. However, high-intensity aerobic exercise significantly increased hippocampal adult neurogenesis relative to the control. A trend towards increased adult neurogenesis was observed in the low-intensity aerobic group compared to the control group. No significant changes in synaptic plasticity were observed among all groups. Our results indicate that high-intensity aerobic exercise may be the most potent stimulator of adult hippocampal neurogenesis.

The Effect of Exercise on Intraocular Pressure and Glaucoma.

A review of the literature found that certain types of exercise and physical activity result in transient reductions in intraocular pressure and may have a beneficial effect on glaucoma severity and progression. Glaucoma is the most common cause of irreversible vision loss worldwide. Raised intraocular pressure (IOP) is the most important risk factor for the disease. Exercise is known to result in changes in IOP. The purpose of this review was to investigate the effect of exercise on IOP and glaucoma. A comprehensive search of multiple literature databases was performed. Medline, EMBASE, and Cochrane libraries were used to search for the relevant terms. 16 original studies were selected for the review. Exercise of varying intensity and type has differing effects on IOP. Moderate-intensity aerobic exercise results in transient reductions in IOP, while high-intensity resistance exercise and weight-lifting lead to transient elevations in IOP. There is evidence to suggest that exercise and higher levels of fitness may be protective against the development of glaucoma. In addition, increased daily physical activity may be associated with less visual field progression in patients with glaucoma. While secondary causes of glaucoma are included in some of the studies discussed in this review, the findings are largely applicable to primary open angle glaucoma. Exercise may be a beneficial lifestyle modification in the management of glaucoma; however, further longitudinal studies are required to validate this.

SOLVING THE HIGH-INTENSITY MUTLIMODAL TRAINING PRESCRIPTION PUZZLE: A SYSTEMATIC MAPPING REVIEW

INTRODUCTION & AIMS High-Intensity Multimodal Training (HIMT) refers to all styles of high-intensity combined aerobic, resistance and/or bodyweight exercise. Previous heterogeneity in exercise prescription and reporting in HIMT reduces the understanding of which factors should be commonly considered when prescribing HIMT (e.g., exercise volume, intensity, duration). Previous studies have demonstrated positive effects of HIMT on health and performance outcomes. However, methodological disparities limit comparisons between findings. This systematic mapping review examines the prescriptive considerations and health and performance outcomes of HIMT in the context of training. METHODS A systematic literature search was conducted using Ovid Medline, SPORTDiscus and Cochrane Library databases and additional sources to identify studies up until February 2023. A total of 37090 records were retrieved, of which 221 were included for review. 247 individual HIMT protocols were included for categorical analysis against the Consensus on Exercise Reporting Template (CERT) and Applied Research Model for the Sport Sciences. RESULTS A total of 85 unique terms were used to describe HIMT. Included studies most commonly prescribed HIMT using a consistent exercise selection and circuit format. Exercise intensity was inconsistently reported on and a large proportion of studies incorrectly prescribed ‘high-intensity’ exercise according to ACSM definitions (i.e., <77% HRmax). Participation location, supervision and participation format were the most commonly reported non-training variables. The most frequently reported outcomes were cardiovascular health, perceptual outcomes, body composition and biochemical outcomes. A large proportion of previous HIMT research was experimental in design. CONCLUSIONS Previous HIMT research demonstrates a lack of standardisation in reporting. Future studies should seek to follow guidelines such as the CERT to improve reporting rigour. Additionally, forthcoming research should attempt to actively involve practitioners in implementation studies to improve ecological validity among interventions. REGISTRATION This review adhered to PRISMA-ScR guidelines. Preregistration: osf.io/yknq4.

The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results.

Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.

Differences in the recovery response from high-intensity and high-volume resistance exercise on force, reactive agility, and cognitive function

PurposeThis study compared the recovery response of physical performance and cognitive function between high volume, low intensity (HV) and high intensity, low volume (HI) resistance training in resistance trained men.MethodsEight recreationally resistance trained men (27.8 ± 1.6 y; 85.5 ± 11.2 kg; 178.4 ± 8.3 cm), with at least one-year of resistance training experience (6.4 ± 3.9 y) participated in this cross-over design study. Participants were randomly assigned to either HV (6-sets of 15–20 repetitions at 60% of the participant’s one-repetition maximum (1RM), 1-min rest between sets) or HI (6-sets of 3–5 repetitions at 90% 1RM, 3-min rest between sets). Following a one-week recovery period, participants reported back to the laboratory and performed the other training session. Cognitive function (SCAT5), physical performance (isometric mid-thigh pull), and reactive agility measures were assessed at baseline, immediately-post (IP) and at 30- (30P) and 60-minutes post-exercise.ResultsParametric analysis revealed no differences in peak force (p = 0.423), and the rate of force development at 200 ms (p = 0.827) and 250 ms (p = 0.797) between HI and HV. However, magnitude-based inference (MBI) analysis indicated that peak force was possibly decreased at 30P following HI and that reactive agility was likely negatively impacted at IP following HV. Friedman analysis indicated a significant decline (p = 0.035) in delayed memory during HV at IP and 30P.ConclusionsResults of this study indicate that participants engaging in HV resistance training are more susceptible to experiencing performance declines in reaction time and cognitive function than HI training. These findings shed light on differences in physical and cognitive function recovery from HI and HV training programs.

Prehabilitative high-intensity interval training and resistance exercise in patients prior allogeneic stem cell transplantation

Physical capacity prior allogeneic stem cell transplantation (allo-HCT) has been shown as a relevant prognostic factor for survival after transplant. Therefore, we evaluated feasibility and preliminary efficacy of a high-intensity interval training (HIIT) and moderate to high-intensity resistance exercise (RE) to increase physical capacity in patient’s prior allo-HCT. In this multicentre single arm pilot study, a supervised exercise program was performed twice weekly for 4–12 weeks prior allo-HCT, depending on the individual time remaining. Outcomes were feasibility (recruitment, adherence, safety), physical capacity (cardiorespiratory fitness [VO2peak], muscle strength) and patient reported outcomes (physical functioning, fatigue). Thirty patients were intended, 16 could be included, and 14 completed post intervention assessment (75% male, 55 ± 11 years). The study was stopped early due to a low recruitment rate. Nine patients (64%) reached the initial minimum planned number of eight exercise sessions. Individual adherence was high with 92% for HIIT and 85% for RE. 87% of all performed exercise sessions were completed without complaints and VO2peak increased significantly from 20.4 to 23.4 ml/kg/min. The low recruitment rate suggests that initiation of the intervention concept immediately before allo-HCT is feasible only in a small number of patients. In particular, the timeframe directly prior allo-HCT seems too short for exercise interventions, although the exercise program was designed to improve outcomes in a very short time frame. HIIT and RE were feasible, effective and well accepted by the included patients.

Changes in Arterial Stiffness in Response to Blood Flow Restriction Resistance Training: A Narrative Review.

Arterial stiffness naturally increases with age and is a known predictor of cardiovascular morbimortality. Blood flow restriction (BFR) training involves decreasing muscle blood flow by applying a strap or a pneumatic cuff during exercise. BFR induces muscle hypertrophy even at low intensities, making it an appealing option for older, untrained individuals. However, BFR use in patients with cardiovascular comorbidities is limited by the increased pressor and chronotropic response observed in hypertensive elderly patients. Furthermore, the impact of BFR on vascular function remains unclear. We conducted a comprehensive literature review according to PRISMA guidelines, summarizing available data on the acute and long-term consequences of BFR training on vascular function. Although evidence is still scarce, it seems that BFR has a mild or neutral long-term impact on arterial stiffness. However, current research shows that BFR can cause an abrupt, albeit transient, increase in PWV and central blood pressure. BFR and, preferably, lower-body BFR, should be prescribed with caution in older populations, especially in hypertensive patients who have an exacerbated muscle metaboreflex pressor response. Longer follow-up studies are required to assess the chronic effect of BFR training on arterial stiffness, especially in elderly patients who are usually unable to tolerate high-intensity resistance exercises.

Therapeutic Photobiomodulation Before Strenuous Exercise Attenuates Shoulder Muscle Fatigue.

Photobiomodulation therapy (PBMT) applied as a preconditioning treatment before exercise has been shown to attenuate fatigue and improve skeletal muscle contractile function during high-intensity resistance exercise. Practical implications for preconditioning muscle with PBMT prior to fatiguing exercise include a safe and non-invasive means to enhance performance and reduce the risk of musculoskeletal injury. To examine the muscle fatigue attenuating effects of PBMT on performance of the shoulder external rotator muscle group when applied as a preconditioning treatment before high-intensity, high-volume resistance exercise. Sham-controlled, cross-over design. Laboratory. Twenty healthy men (n=8) and women (n=12) between the age of 18 and 30. PBMT was administered using a near-infrared laser (λ=810/980nm, 1.8 W/cm2, treatment area = 80cm2-120 cm2) to the shoulder external rotator muscles at a radiant exposure of 10 J/cm2. Subjects performed 12 sets of isokinetic shoulder exercise. Each set consisted of 21 concentric contractions of internal and external rotation at 60°/s. The sets were subdivided into 3 blocks of exercise [Block 1: sets 1-4; Block 2: sets 5-8; Block 3: sets 9-12]. normalized peak torque [Nm/kg], average peak torque [Nm], total work [Nm], and average power [W]. During the last block of exercise (sets 9-12), all performance measures for the active PBMT condition were 6.2% to 10% greater than the sham PBMT values (p < 0.02 to 0.001). PBMT attenuated fatigue and improved muscular performance of the shoulder external rotators in the latter stages of strenuous resistance exercise.

Muscle Mass and Muscle Strength Following 6 Weeks of Blood Flow Restriction Combined with Low-Intensity Strength Training in Overweight Adolescents

Background and Study purpose. Blood flow restriction training is a new training technique that involves low-intensity exercise and can generate physiological changes equivalent to high-intensity exercise. The aim of this study is to assess the impact of blood flow restriction in conjunction with low-intensity resistance exercise on muscle mass and muscle strength among overweight adolescents, in comparison to conventional resistance exercise. Materials and methods. The study involved two randomized groups: an experimental group, which performed 40% of one repetition maximum (1RM) resistance exercise combined with 60% of arterial occlusion pressure (AOP), and a traditional resistance exercise group, which performed 70% of 1RM resistance exercise. All participants underwent pre-test and post-test evaluations for body composition, 1RM, and muscle circumference. The training program lasted for six weeks and consisted of upper and lower body training, including exercises such as leg press, leg curl, arm curl, and arm extension. Results. The group that underwent low-load blood flow restriction (LLBFR) training showed a notable increase in muscle mass (p&lt;0.049) as well as arm and leg circumference (p&lt;0.047 and p&lt;0.046, respectively) compared to before the training program, similar to the results of high-intensity resistance exercise. Conclusions. Combining blood flow restriction with low-intensity resistance training is a potentially effective approach to increase muscle size and strength, especially in overweight adolescents. Moreover, this type of training can decrease the amount of exercise load, making it a feasible option for individuals who may not tolerate high loads due to certain medical conditions or other limitations.

"We want more": perspectives of sarcopenic older women on the feasibility of high-intensity progressive resistance exercises and a whey-protein nutrition intervention.

This qualitative study is nested within a 12-week pilot randomized-controlled, two-arm trial involving high-intensity progressive resistance training (PRT) or PRT with a multi-nutrient, whey-protein supplementation (PRT+WP) in sarcopenic older adults (trial registration no: TCTR20230703001). The aim was to investigate sarcopenic participants' perceptions and barriers to this multi-modal intervention strategy that may accelerate "real-world" implementation. Eighteen older adults (one man) with possible sarcopenia were invited to join the study, of whom 16 women were randomized to a thrice-weekly PRT (n = 8) program (80% of 1-repetitive maximum, six resistance band exercises) only or PRT plus daily weekday milk-based WP supplementation (PRT+WP, n = 8). Muscle strength (handgrip and 5-times sit-to-stand), mass (dual-energy X-ray absorptiometry), performance (Short Physical Performance Battery and stair ascent-descent), and nutrition status (Mini Nutritional Assessment) were assessed for changes. We randomly selected eight women for the semi-structured interview. Post-intervention, eight (50%) women were sarcopenia-free, six (38%) remained in possible sarcopenia, one (6%) improved to sarcopenia, and one (6%) deteriorated from possible to severe sarcopenia. There were no significant between-group differences, but significant within-group improvements (p < 0.05) were detected for handgrip strength (PRT+WP 5.0 kg, d = 0.93; PRT 6.1 kg, d = 0.55), 5-times sit-to-stand time (PRT 2.0 s, d = 1.04), nutrition score (PRT+WP 3.44, d = 0.52; PRT 1.80, d = 0.44), and stair ascent time (PRT+WP 0.97 s, d = 0.77; PRT 0.75 s, d = 0.97). Our thematic analyses identified four main themes, namely, (1) perceived benefits, (2) sustaining behavior changes, (3) challenges in participating, and (4) improved wellbeing. Participants expressed how they initially were skeptical and doubted that they could complete the exercises or tolerate the milk-based WP supplements. However, they reported positive experiences and benefits felt from strength gains, increased confidence, and better physical abilities. Participants were surprised by the zero adverse effects of WP supplements. The women wanted more nutritional information and structured, guided exercise programs and suggested a community-based implementation. In conclusion, our findings showed PRT was well received and may support reduced risks of sarcopenia. No added benefits were seen with the addition of WP supplementation, but a larger sample is required to address this question. Overall, older (previously sarcopenic) Malay women indicated that they want more multi-modal programs embedded in their community.

Effect of Blood Flow Restriction in Low-Intensity Resistance Training of the Quadriceps Femoris Muscle on Joint Position Sense and Threshold to Detect Passive Motion in Patients with Knee Osteoarthritis

Backgrounds: The functional ability of knee OA (KOA) patients is mainly affected by muscle weakness and poor proprioception function. Quadriceps femoris strengthening exercises can improve proprioceptive function in patients with KOA, whereas low-intensity resistance exercises with Blood Flow Restriction have been shown to produce hypertrophy and increase muscle strength equivalent to high-intensity resistance exercises. However, prescriptions for exercise with BFR are still very diverse, and only a few studies show the effects of BFR training on proprioceptive function in patients with KOA. This study aims to determine the impact of BFR in LI-RT of the quadriceps femoris muscle on joint position sense and threshold to detect passive motion in patients with KOA. Methods: This randomized control trial study designed a clinical experiment with a before and after test. The research enrolled 28 people with KOA grades 2 and 3. The JPS and TTDPM, which reflect proprioceptive function, were measured before and after 6 weeks of exercise. This study's statistical analysis utilized the Monte Carlo test, independent t-test, and paired t-test. The effect size was noticed using Cohen's-d calculation to investigate the statistical influence of alterations further. The significance level was less than 0.05. Results: The mean age of the control group was 61.43 ± 5.70 years old, and the treatment group was 57.71 ± 5.25 years old. There were significant improvements in JPS and TTDPM results before and after training in each group (p &lt; 0,05). There was no significant difference in JPS and TTDPM results between the two groups on the post-test on delta values (p&gt; 0,05). Conclusions: The addition of BFR in LI-RT for 6 weeks did not affect JPS and TTDPM in patients with KOA.

Older females but not males exhibit increases in cerebral blood velocity, despite similar pulsatility increases after high-intensity resistance exercise.

Sex differences in resting cerebral hemodynamics decline with aging. Acute resistance exercise (RE) is a hypertensive challenge that might reveal sex-dependent abnormalities in cerebral hemodynamics. Thus, we hypothesized cerebral blood velocity and pulsatility responses to RE would be sex-dependent in older adults. Fourteen older females and 11 males [50-68 years] completed a high-intensity unilateral isokinetic knee flexion/extension exercise. Measurements were collected at baseline, immediately, 5-and 30-min post-RE. Blood pressure was measured via finger photoplethysmography. Mean middle cerebral artery blood velocity (MCAv) and pulsatility were assessed via transcranial Doppler ultrasound. Carotid pulsatility was obtained via duplex ultrasound. MCAv increased immediately after RE in older females (mean difference (d)= 6.02, 95% CI: 1.66 to 10.39 cm. s-1, p<0.001) but not in males (d= -0.72, 95% CI: -3.83 to 5.27 cm.s-1, p=0.99). Followed by similar reductions 5-min post-RE in older females (d= -4.40, 95% CI: -8.81 to -0.10 cm.s-1, p=0.045) and males (d= -6.41, 95% CI: -11.19 to -1.62 cm.s-1, p=0.003). MCAv pulsatility increased similarly in older females (d= 0.24, 95% CI: 0.11 to 0.40, p<0.001) and males (d=0.38, 95% CI: 0.20 to 0.53, p<0.001), persisting 5-min post-RE. Older females showed smaller increases in carotid pulsatility immediately after RE (d= 0.18, 95% CI: 0.03 to 0.38, p=0.01) than males (d=0.48, 95% CI: 0.26 to 0.68, p<0.001). An exercise-mediated hypertensive stimulus revealed differential sex responses in MCAv and carotid pulsatility but not in cerebral pulsatility. Cerebral pulsatility findings suggests a similar sex susceptibility to cerebrovascular abnormalities following an exercise-mediated hypertensive stimulus in older adults.

Intense exercise for survival among men with metastatic prostate cancer: 12 months feasibility results from the INTERVAL-GAP4 trial.

81 Background: Exercise is now considered an important therapy to ameliorate treatment side effects, improve quality of life and physical function however, causation of survival benefit and the underlying mechanisms is not yet established. In 2015, the Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4) – a worldwide multicentre phase III trial – was launched to determine if high-intensity combined resistance and aerobic exercise plus psychosocial support improves overall survival in men with metastatic prostate cancer. Here, while exercise delivery and follow-up assessments are still taking place in 6 different countries, we aim to examine the feasibility, exercise compliance and safety of a 12-month exercise medicine program in patients with mCRPC. Methods: Experimental design was a longitudinal analysis of attrition rates, exercise attendance and compliance metrics and programme safety over the initial 12 months of patients participating in the INTERVAL-GAP4 trial at the Edith Cowan University site in Perth, Australia. Results: 201 patients were screened for participation and 46 patients (22.9%) were randomly assigned to the two study arms. Median time since prostate cancer diagnosis was 72.0 (interquartile range (IQR): 19.5-118.5) months. Most patients were previously treated with radiotherapy (53.3%). Metastases present mostly in the lymph nodes (53.3%), followed by bones (51.1%), lungs (2.2%) and bladder (2.2%). Participants attended a total of 2,907 out of 3,744 exercise sessions scheduled, with a median exercise attendance of 78.8% (IQR: 71.6%-82.7%) per participant. Majority of sessions were performed at an RPE of 7-8 indicating “vigorous intensity” or at an RPE of 5-6 indicating “moderate intensity” (67.2%). Tolerance was moderate-to-high in most sessions (83.0%). 191 adverse events (AEs) were observed throughout the study period. A total of 136 adverse events were reported by 19 participants from the exercise group, and these were mainly disease related (n= 69, 50.7%). Most AEs were grade 1 and 2 (n= 126, 92.7%). In the control group, 55 AEs were observed, and these were mainly disease related (n= 22, 40.0%) and grade 1 and 2 (n= 51, 92.7%). The most common intervention-related adverse events experienced in the exercise group were pain (n= 6, 50.0%; i.e., back pain, bone pain, lymph node pain, and general pain). Conclusions: Patients with mCPRC can participate in high-intensity aerobic and resistance training with moderate to high attendance and tolerance. The exercise intervention appears safe with limited intervention-related adverse events experienced and mostly minor and expected. However, with only 22.9% of screened patients deemed suitable and willing, this aspect of feasibility requires attention. Clinical trial information: NCT02730338 .

Quantifying Insulin-Mediated and Non-Insulin-Mediated Changes in Glucose Dynamics during Resistance Exercise in Type 1 Diabetes.

Exercise can cause dangerous fluctuations in blood glucose in people living with type 1 diabetes (T1D). Aerobic exercise, for example, can cause acute hypoglycemia secondary to increased insulin-mediated and non-insulin-mediated glucose utilization. Less is known about how resistance exercise (RE) impacts glucose dynamics. Twenty-five people with T1D underwent three sessions of either moderate or high intensity RE at three insulin infusion rates during a glucose tracer clamp. We calculated time-varying rates of endogenous glucose production (EGP) and glucose disposal (Rd) across all sessions and used linear regression and extrapolation to estimate insulin- and non-insulin-mediated components of glucose utilization. Blood glucose did not change on average during exercise. The area under the curve (AUC) for EGP increased by 1.04 mM during RE (95% CI: 0.65-1.43, p < 0.001) and decreased proportionally to insulin infusion rate (0.003 mM per percent above basal rate, 95% CI: 0.001-0.006, p = 0.003). The AUC for Rd rose by 1.26 mM during RE (95% CI: 0.41-2.10, p = 0.004) and increased proportionally with insulin infusion rate (0.04 mM per percent above basal rate, CI: 0.03-0.04, p < 0.001). No differences were observed between the moderate and high resistance groups. Non-insulin-mediated glucose utilization rose significantly during exercise before returning to baseline roughly 30-minutes post-exercise. Insulin-mediated glucose utilization remained unchanged during exercise sessions. Circulating catecholamines and lactate rose during exercise despite relatively small changes observed in Rd. Results provide an explanation why RE may pose a lower overall risk for hypoglycemia.

Effects of Exercise on Body Composition and Physical Function in Rheumatoid Arthritis Patients: Scoping Review.

In rheumatoid arthritis (RA) patients, an adverse change in body composition, which usually results in muscle wasting and increased fat mass, is high, contributing to increased functional disability. There are indications that resistance and dynamic exercise interventions could improve body composition and functional capacity in RA patients and should be recommended to manage RA. The scoping literature review aimed to analyze available literature about the effects of exercise on body composition in RA patients. Secondly to identify the contribution of exercise to improve physical function in RA patients, thirdly to identify gaps in the literature about physical exercises and health outcomes in RA patients, and make recommendations for future research. A scoping literature review design was employed following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A systematic search of three databases (PubMed, CINAHL, and Scopus) for studies published from 2012 to 2022 was conducted. The words searched include "exercise intervention" AND "body fat" OR "muscle wasting" OR "lean body mass" AND "functional ability" OR "health assessments". The search strategy was limited to studies published in English on RA patients and exercise interventions. This search yielded 2693 studies, of which 11 met the inclusion criteria and were selected for review. The findings showed significant, positive effects of exercise interventions on RA patients' body composition and functional capacity, with exercise being highly beneficial. It is evident that high-intensity resistance exercise, as a stand-alone intervention, is feasible and safe for managing RA conditions. Physical exercises, following scientific guidelines, should be included as an integrated approach to managing RA conditions.

Analysis of the effects of physical activity on chronic diseases based on multidimensional data analysis

Abstract In recent years, the incidence of chronic diseases in the middle-aged and elderly population has been increasing, with high morbidity, disability, and mortality rates, and is one of the most dangerous factors leading to death in middle-aged and elderly people. Although drugs are the most common means of treating chronic diseases, long-term medication can bring serious side effects and cause chronic damage to multiple organs. Evidence-based medical evidence shows that sports prescription interventions have better intervention effects on chronic diseases without side effects, and they have become a common means to promote recovery and improve the quality of life of patients with chronic diseases. In this paper, we will analyze the effects of different sports on the indicators of chronic diseases from a multidimensional perspective and develop a scientific sports prescription to help patients with chronic diseases recover. The experimental results show that high-intensity intermittent exercise and resistance exercise also have good intervention effects on patients with chronic diseases; in addition, different exercise prescription factors such as exercise intensity, exercise time, and exercise items directly affect the intervention effects of exercise, and unscientific exercise prescriptions not only fail to promote patients’ recovery but also bring adverse effects on patients’ physical functions and even aggravate the development of the disease. The recovery of the physical function of the patients in the experimental group is sufficient to show the feasibility of exercise intervention. Therefore, the development of scientific exercise intervention prescriptions is of great significance to the rehabilitation of patients with chronic diseases.

168-LB: A Randomized Crossover Trial Comparing Glucose Control between Different Exercise Types in Adolescents with Type 1 Diabetes Using a Hybrid Closed-Loop System

Background: Hybrid closed loop (HCL) systems may mitigate the glycemic impact of different exercise types in youth with type 1 Diabetes. Aims: Glucose was compared during and following moderate intensity exercise (MIE), high intensity interval exercise (HIE) and resistance exercise (RE) in adolescents using HCL insulin delivery. Methods: Adolescents using HCL (Medtronic Minimed 670G) undertook 40 min of MIE, HIE and RE in random order. A temporary glucose target was set 2 hours prior and during exercise with 15g carbohydrate given pre-exercise if glucose level was &amp;lt;126mg/dL. A standardized dinner was eaten 4 hours after exercise. The primary outcome was sensor glucose percentage time in range 70-180mg/dL (TIR) for 12 hours from exercise onset. Results: Twenty-eight participants (50% female); age [mean (SD)] 16.3(2.1) years; diabetes duration 9.4(4) years; HbA1c 7.3(0.6)% [56(7)mmol/mol], completed the study. In the 12 hrs following exercise onset the TIR for MIE was [median (IQR)] 76(60-92)%, HIE 87(78-96)% and RE 85(69-94)% (MIE v HIE; (p=0.015). Time &amp;gt;180mg/dL (TAR) was greater for MIE v HIE (18[3-25]% v 7[0-15]%; p=0.041). Time &amp;lt;70mg/dL (TBR) did not differ between MIE, HIE and RE [0 (0-7)%; 2(0-9)%; and 2(0-10)% respectively]. After the post-exercise meal (280-715mins), TIR for MIE was lower than HIE [86(76-96) v 67(49-87)%; p=0.003] and TAR was higher for MIE than HIE [5(0-19) v 28(0-41)%; p=0.012]. There was no significant difference between exercise types in TIR, TAR and TBR during exercise (0-40min) and before dinner (40-280mins). There was a total of 8 episodes of hypoglycemia (15mins &amp;lt;54mg/dL) each for MIE and RE and 5 for HIE. Conclusion: Glucose control in the post meal period following exercise differed between HIE and MIE but not RE. Hypoglycemia occurred across all exercise types. Disclosure R. Seckold: None. D. Morrison: None. J. Rafferty: None. S. R. Valkenborghs: None. B. Paldus: None. D. P. Zaharieva: Speaker's Bureau; American Diabetes Association. Research Support; Hemsley Charitable Trust, International Society for Pediatric and Adolescent Diabetes, Insulet Corporation. Advisory Panel; Dexcom, Inc. Speaker's Bureau; Ascensia Diabetes Care, Medtronic. M. C. Riddell: Stock/Shareholder; Supersapiens. Advisory Panel; Zealand Pharma A/S. Speaker's Bureau; Dexcom, Inc. Consultant; Lilly Diabetes. Speaker's Bureau; Novo Nordisk, Sanofi. Stock/Shareholder; Zucara Therapeutics. Advisory Panel; Zucara Therapeutics, Indigo Diabetes. Consultant; Eli Lilly and Company, Jaeb Center for Health Research. C. E. Smart: None. D. N. O'Neal: None. B. R. King: None. Funding JDRF (3-SRA-2018-532-M-B)

Effects of different modes and intensities of exercise on longevity proteins in middle-aged mouse skeletal muscle.

Physical exercise represents one of the most effective approaches to anti-aging. The goal of this study was to verify the effects of different modes and intensities of exercise on longevity proteins in the skeletal muscle in midlife. Middle-aged mice were trained in aerobic or resistance exercise for 8 weeks, and the changes in sirtuin 1 (SIRT1), adenosine monophosphate-activated kinase (AMPK), and mammalian target of rapamycin (mTOR) pathways in the skeletal muscle were evaluated by western blotting. Long-term exercise had no effects on skeletal muscle SIRT1 abundance, whereas high-intensity aerobic exercise increased AMPK phosphorylation and peroxisome proliferator-activated receptor-γcoactivator-1α (PGC-1α). Low-intensity resistance exercise facilitated Akt/mTOR/p70 ribosomal protein kinase S6 (p70S6K) signaling but did not induce muscle hypertrophy. Conversely, high-intensity resistance exercise stimulated muscle hypertrophy without phosphorylation of mTOR signaling-related proteins. These results suggest the importance of setting exercise modes and intensities for anti-aging in midlife.

Acute changes in affective valence and perceived distress predict reductions in PTSD symptom severity

There is a growing amount of experimental evidence demonstrating therapeutic chronic effects of exercise (e.g., resistance exercise, running, and walking) on PTSD symptoms. However, it is currently unclear how individuals with PTSD experience exercise within individual exercise sessions (e.g., pleasurable or distressing), and if these acute experiences influence PTSD symptoms over time. Purpose: The objective of this study was to examine the acute effects of high intensity resistance exercise on affect, perceived arousal, and distress among individuals who screened positive for PTSD, using a randomized controlled design. Additionally, this study sought to explore longitudinal relations among affect, arousal, distress, and PTSD symptom severity. Methods: This study analyzed pooled data from two methodologically similar randomized controlled trials (i.e., a pilot and replication study). Participants (n = 52) were randomly assigned to exercise or non-exercise time-matched control. Data were analyzed with a series of longitudinal mixed-effects regression models. Results: The analyses suggest that positive affect increased, and distress decreased significantly during exercise sessions, relative to control. Independent of group, increases in positive affect and decreases in distress also significantly predicted decreases in PTSD symptom severity over the course of the study. Conclusions: Taken together, these findings suggest that high intensity resistance exercise is safe for individuals who screen positive for PTSD, pleasurable, and may have a therapeutic impact on trauma survivors. No evidence for symptom exacerbation was found. Future experimental studies are needed to verify these findings and determine if the observed relationships are similar for other exercise modes, durations, and intensities.

Acute Responses to High-Intensity Back Squats with Bilateral Blood Flow Restriction.

This study examined the acute effects of high-intensity resistance exercise with blood flow restriction (BFR) on performance and fatigue, metabolic stress, and markers of inflammation (interleukin-6 (IL-6)), muscle damage (myoglobin), angiogenesis (vascular endothelial growth factor (VEGF)). Thirteen resistance-trained participants (four female, 24.8 ± 4.7 years) performed four sets of barbell back-squats (75% 1RM) to failure under two conditions: blood flow restriction (BFR, bilateral 80% occlusion pressure) and control (CTRL). Completed repetitions and pre-post-exercise changes in maximal voluntary isometric contractions, countermovement jump, barbell mean propulsive velocity, and surface electromyography were recorded. Pre-post blood lactate (BLa) and venous blood samples for analysis of IL-6, myoglobin, and VEGF were collected. Ratings of perceived exertion (RPE) and pain were recorded for each set. Fewer repetitions were performed during BFR (25.5 ± 9.6 reps) compared to CTRL (43.4 ± 14.2 reps, p < 0.001), with greater repetitions performed during sets 1, 2, and 4 (p < 0.05) in CTRL. Although RPE between conditions was similar across all sets (p > 0.05), pain was greater in BFR across all sets (p < 0.05). Post-exercise fatigue was comparable between conditions. BLa was significantly greater in CTRL compared to BFR at two minutes (p = 0.001) but not four minutes post-exercise (p = 0.063). IL-6 was significantly elevated following BFR (p = 0.011). Comparable increases in myoglobin (p > 0.05) and no changes in VEGF were observed (p > 0.05). BFR increases the rate of muscular fatigue during high-intensity resistance exercise and acutely enhances IL-6 response, with significantly less total work performed, but increases pain perception, limiting implementation.